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GidMK's profile
Health Nerd
Health Nerd
Health Nerd
Verified account
@GidMK

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Health NerdVerified account

@GidMK

Epidemiologist. Writer (Guardian, Observer etc). "Well known research trouble-maker". PhDing at @UoW Host of @senscipod Email gidmk.healthnerd@gmail.com he/him

Sydney, New South Wales
theguardian.com/profile/gideon…
Joined November 2015

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    1. Health Nerd‏Verified account @GidMK Sep 6

      This study is a common citation of ivermectin believers, has been reported widely, and I think is a great teaching tool in how little effort it takes to be critical about research findings 1/npic.twitter.com/YDZNB1JP5R

      19 replies 279 retweets 881 likes
      Show this thread
    2. Health Nerd‏Verified account @GidMK Sep 6

      2/n The study is here, and has an objectively large impact with nearly a dozen news stories and an Altmetric of 2750https://www.medrxiv.org/content/10.1101/2021.05.31.21258081v1 …

      1 reply 7 retweets 76 likes
      Show this thread
    3. Health Nerd‏Verified account @GidMK Sep 6

      3/n The study is pretty simple - 116 people with Covid-19, randomized to either receive ivermectin or a placebo Reported results were viral load, and more specifically proportion of people with Ct>30 at various time points on PCRpic.twitter.com/ozXyxZwAOj

      2 replies 6 retweets 75 likes
      Show this thread
    4. Health Nerd‏Verified account @GidMK Sep 6

      4/n The authors report a marginally significant benefit at various days using an uncorrected logistic regression, and from this the massive attention sprangpic.twitter.com/5xk5vLDkrH

      2 replies 7 retweets 78 likes
      Show this thread
    5. Health Nerd‏Verified account @GidMK Sep 6

      5/n One of the first things I do when I read randomized trials like this is look at their pre-registration. This is basically what the authors SAID they would do registered BEFORE they did it Here's the pre-reg for this trial:https://clinicaltrials.gov/ct2/show/NCT04429711?term=NCT04429711&draw=2&rank=1 …

      2 replies 10 retweets 105 likes
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    6. Health Nerd‏Verified account @GidMK Sep 6

      6/n Immediately on looking at the pre-registration, there is a HUGE discrepancy with the published results Here's what the authors pre-registered as their exclusion and the flow chart from the study. Notice the difference?pic.twitter.com/eMFPtwG9Y6

      4 replies 10 retweets 93 likes
      Show this thread
    7. Health Nerd‏Verified account @GidMK Sep 6

      7/n It appears that the authors have added an extra exclusion criteria that is applied AFTER randomization and treatment. This is "tested Ct>35" in the first two testspic.twitter.com/V5ZfCZWhv7

      5 replies 10 retweets 109 likes
      Show this thread
    8. Health Nerd‏Verified account @GidMK Sep 6

      8/n Based on the protocol, that implies the sequence of events went like this: 1. patient tests positive, randomized and started treatment 2. Day 2, patient tests Ct>35 3. Day 4, patient tests Ct>35

      4 replies 6 retweets 72 likes
      Show this thread
    9. Health Nerd‏Verified account @GidMK Sep 6

      9/n This is an issue for two reasons - firstly, it's not what the authors said they'd do. Secondly, it means that they are excluding people WHO MEET THEIR PRIMARY OUTCOME (i.e. Ct>30) after randomization and treatment has started

      2 replies 11 retweets 144 likes
      Show this thread
    10. Health Nerd‏Verified account @GidMK Sep 6

      10/n This makes absolutely no sense to me. These people were randomized and treated, and they met the inclusion criteria pre-registered by the authors. Why were they excluded?

      3 replies 10 retweets 104 likes
      Show this thread
      Health Nerd‏Verified account @GidMK Sep 6

      11/n If you add these people back in, the results of the study entirely lose their significance At day 10, this would be 87% of the ivm and 77% of the control reaching the primary endpoint, p=0.16pic.twitter.com/UjgaGpjYFw

      11:32 PM - 6 Sep 2021
      • 17 Retweets
      • 170 Likes
      • Tubohm Rebecca Jamie Harding Humble Bee Dudu Lagziel Col. Willy von Schnitzelburger Josh Wang james_robinson Daisy_B
      2 replies 17 retweets 170 likes
        1. New conversation
        2. Health Nerd‏Verified account @GidMK Sep 6

          12/n In addition, the authors pre-registered 3 primary outcomes. I can only see one (viral clearance) properly assessed in the paper (shedding is somewhat assessed, but it looks like they didn't get enough samples to statistically analyse this)pic.twitter.com/wv4hnBhNNE

          1 reply 6 retweets 80 likes
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        3. Health Nerd‏Verified account @GidMK Sep 6

          13/n Anyway, the main issue is that, if you use the pre-registered protocol, the study appears to have null results And yet, reported as positive to massive worldwide acclaim 🤷‍♂️

          1 reply 14 retweets 181 likes
          Show this thread
        4. Health Nerd‏Verified account @GidMK Sep 6

          14/n This has nothing to do with fraud, takes literally minutes to check, and I encourage everyone to do so. Please let me know if I've made an error somewhere

          1 reply 6 retweets 146 likes
          Show this thread
        5. Health Nerd‏Verified account @GidMK Sep 6

          15/n Also, to be clear - I'm not accusing the authors of any research misconduct, this is just very basic due diligence that everyone should do for any trial that they read

          13 replies 6 retweets 133 likes
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        6. Health Nerd‏Verified account @GidMK Sep 7

          16/n Also worth noting that it is entirely possible the study still has some positive results when you add these patients back in - the point is their primary outcome, which is the main thing reported, seems to change substantially when these people are included!

          10 replies 6 retweets 94 likes
          Show this thread
        7. End of conversation
        1. Mark Zlochin - מארק זלוצ'ין‏ @MarkZlochin Sep 7
          Replying to @GidMK

          Just a small comment - the primary endpoint as defined in this article was reduction of viral-load on the 6th day, not the 10th (and the results on day 10 are not statically meaningful anyway, even before your correction).

          0 replies 0 retweets 0 likes
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